That's oh-be-GUY-n, not oh-be-GIN, as some (primarily people from Texas) would like to refer to my chosen profession. Although, working in this field can sometimes cause one to develop a penchant for gin...hmmm.

Saturday, October 03, 2009

Overheard in a Beauty Salon

Who knew that having more free time would be counter-productive to blogging? The hardest thing for me is being able to let enough time elapse between bloggable events and actually writing about them, so as not to violate privacy issues. This post, however, happened somewhere that my profession should very rarely come into play, a hair salon. I'm not the first to bemoan the loss of a hairdresser when moving, and, while I held out as long as I could, the root situation was becoming very serious. I got a recommendation from my good friend who lives here in Newville. She's usually brutally honest, and her hair always looks fabulous, so I trusted her opinion. The hairdresser, herself, was fine. Despite trying to sell me on some "organic, sulfate free" shampoo (to a Suave-type girl) at twelve bucks a bottle, she was professional and did a nice job. The fun started when she set me aside for my highlights to process.

As many stylists do, she had stagger-scheduled a client to come in during the time that my highlights were processing. The second client, SC, breezed in and perched in an adjacent seat, waiting for her turn in the chair. "You aren't *pregnant* any more!" exclaimed the stylist to SC. "Nope, delivered 8 weeks early!" SC countered brightly. Needless to say, my interest was piqued, and while I don't make it a habit to eavesdrop, we were the only 3 people in the shop, and they were not discussing things quietly. It wasn't SC's story that surprised me, it was her incredibly flippant tone. I discovered, through their conversation, that SC had developed pre-eclampsia during each of her pregnancies, and this pregnancy was no exception She was admitted to the hospital, where those "incompetent doctors" had the gall to check her blood work every 6 hours and put her on this "vile medication" just in case she had seizures. SC didn't understand while they just didn't "take the baby, already." Finally, she says, after 2 days, her platelets *finally* started to drop, and the decision was made to deliver. She was angry, actually angry, that the baby was delivered after midnight so she couldn't have the "cool birthday date" that she had wanted. Oh, and where was the baby might you ask? He was still in the NICU (no big deal) because he was still apneic, of course. She had just delivered the week prior, by C-section, was obviously in HELLP a very short time ago, and she had driven herself to her hair appointment because she "couldn't stand" the way she looked. She was *glad* she delivered early, because she had only gained 20 pounds, and she was also glad she had "tan lines" so the doctor could see where her bathing suit hit so as not to go above it.

As she went on and on, you could have knocked me over with a feather. I was just shocked and appalled at this woman, so nonchalant about her premature baby, apneic in the NICU, and so unconcerned about her own health, that she was out driving to the hair salon a week after a c-section and HELLP syndrome so she could *look better.* I was blown away at the priorities here. The rest of the hair appointment passed without incident, but I was left to ponder how very differently patients can view their medical situations from their physicians. I am sure that her physician agonized over the decision to deliver her son so early, yet SC had wanted it all done even earlier. I also found it amusing that I cannot escape my profession, even in a place where most go to relax. Have you ever been appalled by an overheard conversation? Maybe next time, I'll bring my i.Pod.

Wow. Just...wow. That is unbelievable. Poor baby. And where is her hubby?? I didn't have a c-section, but my guy drove me everywhere for a few weeks after delivery...just to be safe and to keep me comfortable. Wow.

So sad. I am guardian right now for a child who has been in the hospital for nearly two months due to mother's actions during pregnancy. The mom comes to visit the child once a week if that. People never cease to amaze.Amy in OH

People take pregnancy and birth too much for granted now. Nobody remembers that not so long ago, women and children DIED in childbirth just because of problems like this. We have become so advanced in our ability to care for these people that it's just become routine. So sad.

Not to be shallow, but she is right about sulfate-free shampoo; it does keep your color longer. At the very least, find one without Sodium Lauryl Sulfate, which seems to be the worst offender. I have bright pink hair at the moment for Breast Cancer Awareness Month, and I get the best results with something like L'Oreal Everpure or DHS Clear (which is from teh drugstore and insanely non-allergenic).

I am so impressed that you were able to keep your mouth shut while listening to all this. I doubt I could have done that. Would have butted into the conversation for a little patient education, no, make that hairdresser customer education. Which would have done NO good, which is why you didn't do it! Good job as usual...RuralObGyn

Too be honest with you... Not really a surprise. I'm an L&D nurse at a rural hospital and EVERY SINGLE DAY I have pts who are 32 wks, 34 wks, 35wks ect..., who are SO angry when we terb them or give them mag to stop their ctx. Really? am flabbergasted at how shallow people are when it comes to delivering a healthy full term infant. March of Dimes has put out a great pamphlet on brain development after 34wks... I like to hand that one over for some light reading material as they fume over the unfairness of having to stay pregnant when "OBVIOUSLY the baby WANTS to come out!" Kudos to you for biting your tongue, there IS a benefit of anonimity when you are out and about in town;0)

Congrats for keeping quiet, it had to have been hard. I went to the next town over to have my kids, and overheard some VERY interesting conversations in the OB's office where I sat clutching my board review material behind a copy of Good Housekeeping. And they were, some of them, truly appalling. It's odd how some folks can be like this, while my poor daughter who finally made 36 weeks (by dint of 2 weeks worth of MgSO4, terbuataline, procardia and finally steroids still worries about her baby being early and how he'll do in school (he's fine). If the OB had told her standing on her head would have kept the kid in, she'd have done it! Or at least, in her very pregnant condition,she'd have tried. It's amazing the species survives. It really is true that you can't cure stupid.

i'm an L&D RN and had my son at 25.6 due to HELLP and I wear his current pic and a pic from 3 days old on my badge as sort of a testimony/wakeup call etc for my patients. I've had more than one say "well you were lucky,you never had to get to the big-pregnant stage where nothing fits and you can't eat much, etc" which pisses me off because I would have rather gone to 45 weeks than had him put through so much in his little life. (He's doing great though, very minor bleed, pretty right on for adjusted age).

part of me says take the ipod next time, but then what stories would you tell us? so, for our entertainment i'm going to root for no ipod. ;)

This reminds me of the story a med school friend told me about a women who came into the free clinic and swore she was using safe sex practices and then had a sperm reported in her UA. On careful questioning, it turned out she had no concept what that meant.

Some people have no clue. Clearly that's the case here - but I also wonder if this isn't the false bravado of someone who has experienced something terrifying and has no real way of dealing with it and slips into some sort of denial about the whole thing. This woman is not equipt to make good decisions for herself or her child and that's why discussions of informed consent sometimes seem like nothing more than wishful thinking. Can this person who so clearly does not understand the gravity of her situation really consent to what she does not understand?

I'm not a doctor or nurse, but as the mum of an ex 27 weeker with significant special needs (due to severe TTTS & IUGR) I would NOT have been able to be quiet if I had overheard this conversation. I would have given my right arm to get to 32 weeks!!!

I also could never imagine spending time at the hairdresser while my baby was in the NICU having apnoeas.

Wow! I too, am speechless. I'm a mom of a former 32 weeker. My husband and I spent every waking moment in the NICU. I gained over 80lbs due to preeclampsia and how I looked was the least of my concerns. My second child was delivered via C-section after 10 weeks of bed rest at 36 weeks due to many complications. We barely escaped the NICU with her.

I volunteer in the NICU here in PDX as a parent of a NICU graduate supporting parents with babies in the NICU.

It's because of my personal experience, I'm on my way to becoming a NICU nurse!

OH MY GOD!!!! Seriously? What the hell is wrong with this woman? I had partial hellp with my first daughter and severe pe. Partial hellp because my platelets were ok but my liver enzymes were insane and I had hemolysis. I almost died with my daughter. I have had pe every time (three pregnancies) and I have NEVER wanted my children born early. They were not that early at 35 and 36 weeks! They NEED that time to full time in the womb. She is out and about while the baby was in the NICU? My daughter was readmitted at 4 days old for severe jaundice and dh and I did not leave her side for a second. Someone was ALWAYS with her. I had to leave for the first 2 days while she was in because I had severe pih with her and was on bedrest (and someone told the nursing staff I was supposed to be in bed for severe pih). When I could I came up there with her and stayed in a bed next to her crib.

They are checking her bloodwork for toxicity and to make sure her condition isn't worse! That awful drug SAVED her life.

Unbelievable.

Yeah and pisses me off when people tell me how lucky I am not to have to go through the last month of pregnancy (coming from the receptionist at my ob's office. I wanted to smack her!).

I agree this particular woman sounds like what our office staff would call "a piece of work". I recognize this "type" of patient and, if I'm honest, it is extremely easy to judge and categorize them as soon as they walk through the door. If I am more honest, this can most definitely lead to my not explaining things as well as I could. I might start out very patient and understanding, but gradually lose that patience and become frustrated as she challenges everything I suggest. In the end we all end up talking about her behind her back, and some not-so-nice things get said. ("she's so crazy, I can't even be bothered to try and explain Mag to her again, let's just start it" I might say to a nurse).

Further, if she's already been pre-eclamptic in previous pregnancies, there's (a) a chart documenting that she was "noncompliant" and "a whiner" previously and (b) perhaps an assumption, from patient & physician, that she knows what the drill is and doesn't need it explained again -- this however is assuming that it was explained well in her previous pregnancies, which I'm guessing it wasn't.

I'm a family doctor with small kids and so hear a LOT of stories from patients who have seen specialists, from other parents and from strangers as I'm out and about. Over the years I've learned that the biggest lessons aren't usually what did or didn't happen (because who knows, really, unless you have the chart in your hands), but what people understood was happening and how they perceived decisions to be made.

To me, this woman sounds like she was very dissociated from the whole experience, poorly educated around what was going on, and felt extremely powerless and ignored throughout her whole ordeal. Is she stupid, ignorant and clueless as well? I guess so, but there is a lot more to see in this story, IMHO.

I agree that this story is sad, and this woman completely clueless. However, on a less serious note, I have to agree with Eric-- Your highlights would last a lot longer if you used better quality shampoo.

The beauty shop would be an excellent place to start an educational campaign for preterm birth. Many women just don't know and if their doctors or nurses don't take the time to teach them where would they learn? Most women want to be good mothers, we should assume this of this woman too.

I can't even formulate words into a coherent sentence that would properly express how... ugh. RIDICULOUS! some people can be.

On a happy note- I am a new reader and am really enjoying everything from the very beginning. I think you must *force* Mr. Whoo to write a blog. My girlfriend is not keen on the idea of late nights alone and I've no advice for her!!! Oh Mr. WHOOOOOOOOO! We're pining for YOUUUUUUU.

And I can't understand why some people who come into our triage department at the level III hospital I work at scowl at us, roll their eyes, argue, etc., etc., when we tell them what they don't want to hear, like we're going to try to stop their preterm labor, or that we're not going to admit them and "augment" (they always use the word "induce"), their very early labor when they don't really need to be admitted yet, that there is no benefit to doing a c/section to "just get it out", etc. My favorite was a young woman with twins who we admitted at 28 weeks, contracting like a banshee, 80 percent effaced, 4 cm dilated, who sobbed as she told me "I can't stay. I know my body, and I am not going to have these babies anytime soon"!; not to mention the comments like "My (fill in the blank...sister, aunt, cousin, neighbor, etc.) had a baby at 23 weeks and he/she is just fine!" I of course continue with the "appropriate educational" responses, but inside I'm screaming at them..."Then Why the hell did you come here in the first place if you don't want what we have to offer you!!!!!!!!!"

But we're preaching to the choir. I'd like to see that pamphlet from the March of Dimes(and posters too) placed in every beauty salon, fast food restaraunt, Walmart, Target, KMart, and mall in the country. Public service announcements with every television show. Even if somehow the considerable funds for that were possible, I wonder if it would make any difference. Sigh.

I'm agreeing with most of the posts here, recognizing that this woman is clearly clueless. But must take exception to this comment:

People take pregnancy and birth too much for granted now. Nobody remembers that not so long ago, women and children DIED in childbirth just because of problems like this. We have become so advanced in our ability to care for these people that it's just become routine. So sad.

Sorry, folks, "not so long ago" is TODAY. Women and children are dying in childbirth TODAY, in this country, because of preeclampsia and HELLP syndrome. Sometimes they're dying b/c their healthcare was inadequate; sometimes they're dying b/c they were not educated about the warning signs to get themselves to care soon enough; and sometimes they're dying b/c PE and HELLP are great masqueraders and sometimes defy easy dx and mgmt.

I think Clueless in Salon needed a wake up call as do all women who think they can be so cavalier about pregnancy and childbirth.

OMG. I think my head would have exploded or at least would have had steam coming out of my ears. My son was born at 35 weeks and luckily did just fine. I was so worried that they had to tell me to take a walk outside to get me away from him during rounds. My friend with PE had her twins at full term and they still ended up in the NICU. My hairdresser that I have been going to for years actually makes sure to schedule me away from some of her more dense clients as she knows I don't suffer stupidity well. I don't immediately spout off since I don't want to ruin her business, but I just can't risk an actual cranial explosion if it gets too bad.

Oh. My. GOD. I delivered all three of my kids early (38, 36, and 37 weeks, respectively) due to pe. My third baby spent nine days in the NICU due to TTN. I spent every day going back and forth between my house and the NICU to spend time with my kids at home and my new baby. I can't imagine being flippant about having a baby in the NICU or giving birth early.

I can understand thinking this woman is clueless or ignorant. I used to be a woman like her! I consented to a procedure at 37 wks and didn't have an qualms about my baby maybe being early. She was and had to be in the NICU for a week. It was the worst week of my life. I didn't feel a connection to my daughter at all. I spent more time out of the hospital than in it with her. I actually had thoughts of 'if they switched babies on accident, I would never know since I didn't meet my daughter until 8 hrs after her birth'.

Its so easy to judge this woman for her stupidity, ignorance, or lack of love for her child. But if u look at the entire situation, maybe she is dealing the only way she can. By pretending nothing is wrong. That's what I did with my NICU baby and it ended up becoming PPD and PTSD.

I know there are tons of women that would kill to have a baby go to 32 wks. I am one of them. But that doesn't mean you can know what this woman is thinking and why she is doing what she is doing. Maybe looking well and other things is what keeps her from crying and regretting.

I think this is a good lesson to everyone to maybe think about the backstory a little before you say her tubes should be tied. The NICU is a very hard place for a parent. You feel in the way since you aren't the one truly caring for your baby.

First off, I'm new to these sorts of blogs, but am always amazed at the clever pseudonyms!

Second, I work for a training company that's developing a project on smoking addiction/cessation. We're looking to interview an OB/GYN about how/if smoking addiction is addressed by OB/GYNs when seeing women who may become pregnant. You seem to enjoy discussing your experiences. If you'd like to participate in a phone interview, we would be grateful! I can send you details about the process, but I will tell you up front that we are looking to collect more general information, with strict respect for HIPAA regulations.

If you, or if any OB/GYN peers or colleagues, would be interested in being interviewed, please let me know. We offer $225 for about 1-1.5 hours over the phone.

Wow. I wish I could say that I don't believe someone would be so flippant...but I've seen it myself. There was a woman in my church who had 2 babies at 34 weeks--NICU time for both of them. With her 3rd she called me up all frustrated because her OB--a different one from her first two pregnancies because she had moved 90 miles away--would not do an elective induction at 36 weeks. Her boys had been "okay" at 34 weeks--at least eventually they had...so what was so bad about 36?

I later learned that after I tried to convince her to wait for labor--even pulling scripture into it because she was a pastor's wife--she called up her old OB, pleaded sentimentality and wanting to have the same OB, and got her elective induction at 37 weeks. Can't say I was TOO shocked though, as she was the most miserable pregnant person I knew.

Coming on the scene late...Kayce Pearson made a comment I'd like to echo:

Its so easy to judge this woman for her stupidity, ignorance, or lack of love for her child. But if u look at the entire situation, maybe she is dealing the only way she can. By pretending nothing is wrong.

Psych professionals call this 'escapist coping.' 50 cent words aside, it's not difficult to understand why some people run from change. Change is difficult - and it often takes work. Some people don't have the strength of character or motivation to face the challenges of pregnancy and birth, but some of those people try to become parents despite those hurdles to cross, and that's why they need the support of compassionate, educated and experienced birth professionals.